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Can Migraines Be Prevented?

 Can Migraines Be Prevented?

Can Migraines Be Prevented?


Migraine is a disease that, under various names, has been known since ancient times. Hippocrates, the father of medicine, accurately describes it in the main terms, referring to visual disturbances, headaches and vomiting as the main symptoms of a disease that we are still suffering from today. The name itself comes from the word hemikrania, from which the name migraine, as we call it today, originated, and it rests on the main determinant of the clinical picture - half-head pain.

Can Migraines Be Prevented?

Migraine headache

Migraine symptoms

The incidence of migraines

Treatment of migraines

Prevention of migraine attacks

Monoclonal antibodies

Migraine headache

Occasionally, 80% of the population of our planet suffers from occasional headaches, and between 15 and 20% of these are migraine sufferers.

There is almost no person who has not experienced a headache at least once in their lives. Occasionally, 80% of the population of our planet suffers from occasional headaches, and between 15 and 20% of these are migraine sufferers. In Croatia, about 400,000 people suffer from migraines, with women being three times more affected than men. Many migraine sufferers never go to their doctor, so they are never diagnosed with migraines. Inhabitants are more likely to suffer in urban areas and less frequently in rural areas.

 

Migraine is one of the most common headaches with very characteristic symptoms, so given the length of the headache, the time incidence and symptoms do not require special neuroradiological treatment, but diagnosis in about 90% of cases is made based on the interview with the patient. The pain is pulsatile or dull, with migraine with aura and migraine without aura.

 

Migraine symptoms

The headache itself is often accompanied by nausea, vomiting, sweating, and the patient is disturbed by noise, light and odors that can also provoke a migraine attack.

In migraine with aura, visual disturbances in the form of flashes before the eyes, light vibrations, zigzag light lines, light flies, images of a broken mirror or the patients see broken lines in the form of a fortress plan are most commonly reported. Others list ambiguities, tingling in the area of the face, tongue, half of the body, until the half body is seized. Disturbances are transient in nature - usually the aura ends after an hour. However, although the aura usually precedes the appearance of a headache, sometimes it actually continues on the headache. Complications in the form of a migraine stroke are rare, more commonly in younger women taking hormone therapy. The headache itself is often accompanied by nausea, vomiting, sweating, and the patient is disturbed by noise, light and odors that can also provoke a migraine attack.

 

At the end of the seizure, the patient is exhausted or, on the contrary, feels better as if some relief has occurred. In some people, migraine occurs several times in their lives, but it is a particular companion to the menstrual cycle in women, and it can occur at the time before and just after the onset of menstrual bleeding. It is less frequently noticed during ovulation. It can completely disappear in menopause, but it also often remains, changing its frequency, character of pain and the like. The pain is diffuse or behind the eye, in the temporal region, although it can also begin in the nape of the neck, mimicking headache of the neck, without any direct connection with it.

 

The incidence of migraines

If a migraine-like headache first occurs after the age of 30 or 40, other causes of the headache should be ruled out with complete neurological treatment. When changing the frequency, nature of pain, localization and various neurological outbreaks, especially in middle and older life, it is mandatory to rule out other causes of headache.

 

We often experience migraines in multiple family members, in situations where the mother or father or other relatives have similar disorders, often without a diagnosis. The treatment then becomes experiential, passed down from generation to generation. Thus, it is inadequate, inadequate, wrong, belated and outdated. The opinion of people with migraine without often knowing it is that it cannot be treated, much less prevented. Patients are prone to self-medication. Without the approval of family physicians, they take non-steroidal antirheumatics, as well as combination analgesic drugs that can cause the habit, which must then be treated separately.

 

Treatment of migraines

Side effects of these medicines, length of administration, and attenuation of effect should be considered after an average of six months.

We say a headache is present because "the drug is looking for itself." It is justified to treat migraine headaches with so-called tryptane preparations, as these medicines exhibit the best effect in the onset of a migraine headache. They are useful in preventing the duration of a migraine attack and sometimes its frequency. The prevention of migraine attacks in adults includes three main groups of drugs, namely, antiepileptics, antidepressants and beta-blockers.

 

Their use is justified in cases of migraine attacks of very high intensity, long duration and high frequency. Side effects of these medicines, length of administration, and attenuation of effect should be considered after an average of six months. For the treatment and prevention of acute or chronic migraine, these drugs are most commonly purchased with the recommendation of a neurologist.

 

In the absence and ineffectiveness of various analgesic preparations, patients take preparations of magnesium, vitamin B2, vitamin E, coenzyme Q10, use warm wraps at the beginning of a headache, and cold ones when the headache is severe. There are also aromatherapy and "biofeedback", which are relaxing, and this therapy can be beneficial. Proper nutrition and sleep rhythm can mitigate the effect of stress as a major risk factor for migraines.

 

Prevention of migraine attacks

Avoiding nutritional provocative factors, which contain vasoactive amines and vasoactive substance associations, may reduce the onset of headache. Here belong e.g. chocolate, fermented cheeses, red wine, some nuts and sometimes exotic fruits. Smoking cessation, excessive coffee consumption, and aerobic exercise in the fresh air may be helpful in preventing migraine attacks. The literature cites the use of acupuncture treatments in the treatment of headache as well as the use of botulinum toxin.

 

None of the above medicines and methods for preventing and treating migraine headaches have proven to be quite effective. In many migraine sufferers, therapy has changed, both in the acute onset of headaches and in the desire to prevent migraine attacks.

 

Monoclonal antibodies

Recently, monoclonal antibodies have been discovered that act on the mechanism of pain in the so-called. trigeminovascular system. The drugs in this group (such as fremanezumab and erenumab) act by different mechanisms on the pain transmitters in the said system, and either the pain does not occur or its transmission is stopped on the way to the parts of the brain responsible for the perception of pain. These antibodies are intended to prevent the onset of migraine headaches, as well as to prevent the treatment of frequent migraines accompanied by very severe pain that does not respond to other analgesics.

 

Monoclonal antibodies are a positive shift towards more effective treatment and prevention of migraine headaches, resulting in significant material savings due to the reduction of analgesics and indirect costs such as absenteeism, inability to perform daily activities during headaches and the like. Indirect costs account for over 90% of all migraine-related costs. These medicines are given by injection, monthly or once every three months.

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